Venepuncture

Question 1

Name some indications for taking blood cultures

Answer 1

High/Low temp
Tachycardia
Breathlessness/tachypnoea
Hypoxia
Unexplained confusion
Focal signs of infections
High/Low WCC
Unexplained deterioration
Sepsis screening tool

Question 2

Name some indications for taking blood samples

Answer 2

Diagnostic purposes
Baseline pre-operatively
Monitoring blood components
Monitor drug levels e.g. INR/ Digoxin levels
Cross match
Unexplained illness and / or deterioration

Question 3

Explain timing of when blood cultures should be taken

Answer 3

blood cultures should be taken as soon as bacteraemia is suspected and ideally before commencing antibiotic therapy (or before the next dose is administered if already receiving antibiotic treatment).

if other blood samples are required, blood cultures should be taken first.

Question 4

Which veins do we usually take blood from?

Answer 4

cephalic / basilic and median cubital

blood cultures should only be taken from new sites unless an existing central venous cannula is suspected to be the source of the infection

veins proximal to existing cannulas/ IV infusions must not be used

Question 5

Name some cautions and contraindications to taking blood

Answer 5

CAUTIONS
Areas of fibrosis, infection, oedema, haematoma, bruising

      CONTRAINDICATIONS
Affected sides in patients post mastectomy or stroke
Sites with Fistulas or vascular grafts
Sites with infusions running
Sites of recent  venepuncture

Question 6

Name some complications of taking blood

Answer 6

Pain, bleeding, haematoma, infection
Haemolysis/abnormal blood results (due to tourniquet being on too long)
Syncope

Question 7

Talk through the venepuncture procedure

Answer 7

Collect blood request form, wash hands with soap and water, introduce yourself to patient

-Check patient ID, get informed consent, ask if any allergies, encourage patients to ask questions

• apply apron, clean tray
• remove apron, clean hands

-Apply tourniquet, palpate and identify vein and then remove tourniquet.
Gel hands, apply gloves

• clean vein for 30 secs, allow to dry for 30secs
• remove culture lids and clean with separate swabs for 15-30secs
• Reapply tourniquet, check tightness, prepare blood collection, warn patient of scratch
• fill blue culture bottle first, then red
• continue with other samples required, gently invert 6-8 times

etc